医院分诊移动决策支持原型系统的开发与评价

J. S. Pedro, F. Burstein, J. Wassertheil, Nitin Arora, L. Churilov, A. Zaslavsky
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引用次数: 22

摘要

在没有决策支持的情况下,医院急诊科模糊不清的分诊情况往往难以评估。对这种情况的主观评估可能导致分诊不足或分诊过度,而患者的真实情况往往不能在规定的时间内得到解决。在本文中,我们提出了一个决策支持模型,该模型可以指导临床医生在患者出现模棱两可的分诊病例时识别医疗干预的紧迫性。我们的模型是一种启发式方法,选择最佳分类,识别患者相应的判别属性,并允许临床医生在决策中附加一定程度的信心。我们将这个模型作为一个移动决策支持系统,称为iTriage。使用14个基于纸张的成人分诊场景对iTriage进行初步评估的结果表明,我们的模型对紧急场景产生了稳健的决策。对于非紧急情景,建议的模型提供了指导,特别是当情景表述含糊不清时。
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On Development and Evaluation of Prototype Mobile Decision Support for Hospital Triage
Ambiguous triage scenarios in hospital emergency departments are often difficult to assess without decision support. Subjective assessments of such scenarios can either lead to under-triaging or over-triaging for which true conditions of patients are often not addressed within the required time. In this paper, we propose a decision support model that can guide a clinician when identifying the urgency of medical intervention when patient presents with ambiguous triage case. Our model is a heuristic approach that selects the best triage category, identifies corresponding discriminating attribute of the patient, and allows clinician to attach a level of confidence in the decision. We implemented this model as a mobile decision support system, called iTriage. Results of an initial evaluation of iTriage using fourteen paper-based adult triage scenarios showed that our model produced robust decisions for urgent scenarios. For non-urgent scenarios, the proposed model provided guidance especially when the scenarios were ambiguously stated.
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